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Wednesday, June 5, 2013

Young Adults Should Look for 12-Step Groups With Peers, Expert Advises

Although they make up only a small percentage of 12-step
program membership, teens and young adults can benefit greatly from
attending meetings for groups such as Alcoholics Anonymous (AA) or
Narcotics Anonymous (NA), according to an expert from Harvard
University.Only two percent of AA and NA members are under age 20, and 13
percent are under age 30, says John Kelly, PhD, Associate Professor in
Psychiatry at Harvard Medical School and Director of the Addiction
Recovery Management Service at Massachusetts General Hospital. “Young
people are a minority in these groups, so they may find it more
difficult initially to identify with members who are older and have
different challenges, such as children, elderly parents and job loss,”
said Dr. Kelly.Because of this potential mismatch, he recommends young people who
are looking to start participating in a 12-step program, whenever
possible, begin with meetings that are specially designated for young
people, to help them feel connected and engaged. “After this initial
engagement, however, young adults may find it more beneficial to branch
out to more mixed-age meetings,” he says. “Older people are more likely
to have long-term sobriety, and generally have greater life experience
and wisdom. Our recent findings support the notion that age similarity
is good for early engagement and for enhancing sobriety, but confers
less benefit in the long term.”At the recent National Association of Addiction Treatment Providers
meeting, Dr. Kelly presented research he conducted with 300 young
adults, ages 18 to 24, which looked at participation and involvement in
12-step programs following inpatient substance use disorder (SUD)
treatment. He found high rates of attendance and involvement—speaking up
at meetings—was correlated with even more days of abstinence. The
study, published in the journal Drug and Alcohol Dependence,
found the effect of attendance diminished over time, but the effect of
involvement increased. The study also found having contact with group
members outside of meetings also benefited young adults.

John
Kelly, PhD, Associate Professor in Psychiatry at Harvard Medical School
and Director of the Addiction Recovery Management Service at
Massachusetts General Hospital

His findings suggest that merely attending community 12-step groups,
while helpful, will only take a young adult’s recovery so far.
“Consistent and active involvement maintains and increases the benefit
of participation, resulting in sustained improvement over time,” he
wrote in the journal.A second study, which has not yet been published, found young adults
who attended meetings that had at least some people in the same age
range during their first three months after treatment had better
abstinence rates than those who attended meetings only with older
members. The age-matching effect diminished over the next nine months.His findings with young adults are similar to those in a study Dr. Kelly published last year
that found teens in addiction treatment can benefit from 12-step
programs. The study included 127 teens who were outpatients in substance
use disorder treatment programs. They were assessed when they entered
treatment, and again three, six and 12 months later. The researchers
found greater meeting attendance was independently associated with
significantly better substance use outcomes. Those who were in contact
with a sponsor from AA or NA or who participated verbally during
meetings had an even better outcome over and above the positive effects
from merely attending meetings.Dr. Kelly also presented data from a third study, also not yet
published, that followed 300 young adults with substance use disorders,
half of whom also had a dual diagnosis—most commonly a mood or anxiety
disorder. Overall, patients with dual diagnosis attended as much and
became as involved as those with only an SUD diagnosis, but had
generally worse outcomes. Those with a dual diagnosis who had a high
level of involvement in a 12-step program, however, had outcomes as good
as those with only a substance use disorder, Dr. Kelly says. “This
suggests that, for some, a strong and active connection with AA or NA
can potentially offset a worse recovery prognosis for those with a dual
diagnosis.”“The good news is that clinicians can influence the likelihood that
young people will attend 12-step meetings. If they do attend, they are
likely to have improved outcomes,” Dr. Kelly observes. “If they educate,
prepare and actively link young people with meetings, they are likely
to increase the chances for better outcomes in the year after
treatment.”